Indah

Meet Indah.

She is an absolutely adorable 5-year old girl living in Indonesia. Heather and I have talked for quite some time about sponsoring a child overseas. Well, yesterday we began sponsoring Indah through Compassion International.

From all that I've heard, Compassion Int. is the most prominent and reputable of the companies out there offering relief to underprivileged children around the world. Meaning, more of the dollars you send through Compassion Int. actually make it to the child instead of in administrative costs.

Heather and I are blessed to be in a position to be able to afford sponsorship, but I think many people don't realize that they are also financially able to do this.

We received our water bill in the mail yesterday. Though it was a bit higher than usual, the monthly costs for sending Indah money to help her grow and learn was roughly half the cost of our water bill.

To put it another way, we pay each month almost three times as much for our cell phones each month. And we don't even have the smart phones with the Wi-fis that get on the internets.

Compassion Int. asks for $38 each month to sponsor one child. How many of us spend that much going out to eat on nights we don't feel like cooking? My guess would be, a lot.

I like Compassion Int. also because of their name. In my theology, God is compassion first and foremost before any other trait can be ascribed to God.

Indah's picture is now on our refrigerator, and we look forward to exchanging letters and communications with her in the future.

If you've ever thought about sponsoring a child, let me encourage you to do so. Click here to view children needing sponsorship right now.

Best.

Strokes of genius

I have visited with countless patients who have suffered a stroke. Some were completely immobilized, some seemed still completely normal and able, and many were in between having lost some sort of mobility or means of communication.

Strokes are pretty horrible, generally speaking. A blood clot forms and get lodged somewhere in the brain cutting blood flow to our body's super-computer. Very often, results of strokes are loss or lessened use of the left side of the body, arm, leg, face. As I've said, I've ministered to countless stroke patients, but never have really understood what it is like to be a stroke victim.

Recently, I had the opportunity to learn just a little bit more as a stroke patient recounted his experience just after the stroke happened, and it was scary. We'll call him, Bob, and he lives alone.

Bob was sitting in his favorite chair one evening, resting before bed. Not unusually, he fell asleep. Eventually, Bob woke up and felt strange. Like he could see, but couldn't see right. He looked around the room, and though it was familiar, something was funny, off, different.

Not knowing really what was going on or what had happened, he thought it best to go to bed and sleep it off. He tried to get out of his chair, and all his body did was tremble a bit. He moved, but didn't move. Something was definitely wrong. Trying some more he discovered that he couldn't use his left arm or leg, and his right side was weak. He needed help.

But, how could he get it? No one could hear if he yelled. He thought of how else to get help. A phone! He looked around and spotted his cordless house phone in it's usual spot on the reciever atop the refrigerator. "Only a few steps away," he said to me, "It might as well have been miles away. I've never felt so lonely in my life."

What is normally a simple task of standing up, taking a few steps and picking up the phone whenever it rings was now a monumental, seemingly impossible task. He told me about sitting in isolation, trying, struggling, tearing at himself for what to do, "I must have sat there near an hour trying to figure this out." That may well have been the longest our of his life.

Finally, some determination welled up in him. He used his "good" arm (the weakened right one) and strained as hard as he could, "It's never been so hard to get out of a chair. It was like having to move dead weight, except you are the dead weight." Prying himself from his favorite chair, Bob tumbled onto the floor. Military style, as if with a wounded arm, he painstaking slow pulled himself with his right arm across the smooth luckily linoleum floor toward the refrigerator.

But how would he possibly get up high enough to get that phone. He recounted, "I probably laid there in the floor ten minutes before it hit me." Reaching his arm into the crack between the refrigerator and wall he grabbed and pulled on the cord to the receiver, and the phone came falling to the floor -- plumb out of reach, bouncing over underneath the dining table.

It's a wonder the phone didn't bust into pieces falling from that high, but luckily this one was made sturdy. Bob told me that he didn't have anymore energy to pull himself over the phone. He was able to roll himself to where he could grab a nearby chair leg. And using that chair leg like he was fishing, he tried to bump and knock the phone toward him with the chair leg diagonal from the one he was grasping. Like trying to play golf using the wrong end of the golf club, he was able to nudge that phone of salvation within reach of his exhausted, weakened but usable hand.

This story is like fighting on the battlefield, only the field is your own home. I'm terrified to think of ever having to be in a position like that. Especially, when I heard from Bob's own mouth just how alone he felt when he realized he couldn't move, and no one knew he needed help.

Though he'd had a stroke, I think is was quite a stroke of genius the way he was able to retrieve the phone. Pulling on the cord, using a chair like a fishing pole, the courage it took to drag himself out of his chair an over the floor is something I hope I have inside me if ever presented with such a simple yet daunting task as getting the phone.

Universal Grief

I sat with an Alaska Native woman, whose common law husband was brought into the ER in critical condition. Since she was uncomfortable being right outside the patient room, we wound up sitting together in the waiting area, while she ate and drank with shaky hands, wondering if the staff would allow her the same rights as a legal spouse.

She eventually began telling me about life growing up in the village she lived in and later moving to Anchorage. She then shifted the conversation toward me and commented on the difficulty of being a chaplain. She thanked me for being a calm presence, and then she began to ‘read’ me, as a shaman might, telling me of my gifts, struggles, fears and motivations. Only, she wasn't looking at my palm, she was staring me straight in the eyes. Some of her statements were spot on, others were less accurate. But enough of what she was saying hit close enough to home to make me uncomfortable. She told me that one of her functions in the village was as a healer. She wasn’t the physical kind of healer, but another kind, a healer of the insides. She told me I have the same gift: to be a healer of the insides.

Despite my level of discomfort during this part of the conversation, I felt honored afterward feeling as if she put herself in a vulnerable place by sharing that part of her culture with me. I also felt a little bit humbled, as my usual response to such things is to relegate them to the category of tribal hocus-pocus. However, given this experience, my assumptions are now being re-ordered. One thing was certain, we came from very different cultural backgrounds.

After this ‘reading,’ I was able to redirect the conversation back toward her and the present situation with her live-in partner. And, in the following discussion she seemed to feel much safer, sharing with me her worries, grief and flowing tears. When she cried harder, she spoke a few words in a language I didn’t recognize, presumably the language of her native village. I was blessed to simply sit with her.

This snippet is one of many opportunities I’ve had this unit to minister to and be with people from a culture or cultures either mostly or completely unrepresented in the south. One of the lessons this visit, and others like it, taught me is that grief is universal. While expressions of grief vary between cultures, indeed they vary person to person; the pain of loss seems to remain a constant across humanity.

One social justice issue present in this visit was whether or not the medical staff would treat this woman with all the rights and privileges of a legal spouse or keep her at arms length, because she lacked a piece of paper from the court house with their names on it. In the end, aside from one comment by a nurse, she was treated as the spouse and spokes person for the patient who died soon after in the ER.

Blessing

Before I begin my weekly night shift, the chaplains there in the evening come together and update me on any need-to-know cases. "There's a trauma in the ER but family hasn't arrived yet. The patient in room 100 would like a prayer this evening if you have time. There's a man in surgery now whose wife is an RN here, she's very upset, please check in with her." Things like this and so many other situations get passed along usually giving me a check list to go through before settling in for the night.

Recently, at nightly report, I was told this, "You will probably be called to the Mother-Baby unit tonight. There's a pregnant mom who came in yesterday for her first ultra sound, and everything was fine. This morning she started bleeding, came to the ER, and found out that her baby has died en-utero. She's been induced for labor and says she wants her baby blessed after delivery."

I have to be honest, this is not the kind of referral I look forward to. Baby deaths in the past have been difficult for me. (Read one account here, and how I coped with it here.) However, I have grown as a professional chaplain and matured as a person to the point where, pregnant women and acute compounded grief over loss of a child don't scare me. I am now able to enter their space, sense their pain, and minister within it.

Sure enough, later that night the pager erupted. The baby blessing was requested. This is not my first blessing of an infant, alive or dead, and I haven't done many. But, I must say, as sad as they can be, I really love doing them. In preparation, I grabbed a small plastic heart shaped container that has a little lid (about the size of a 3-liter bottle cap), put in it a cotton ball and poured some anointing oil over it. I took with me a certificate of blessing and one of those crempy sealer things like notaries use to make the certificate feel official.

Entering the room I saw mom, holding her darling deceased baby that weighted about a pound. She was staring at his beautiful tiny wrinkled face as if she was looking into her entire universe. Her dad, grandpa, was quietly sitting nearby. We talked for a few moments but mostly gazed at the little guy who never had a fair shot at life. Mom had already cried so much she was temporarily out of tears and in a sacred and serene place of wonder as she imagined what might have been but now never will be.

She told me his name and why she chose it. Naming helps the grieving process for parents so much as a way to connect with and honor the life that was lost. She had taken pictures of him and dressed him, things parents do, and she would do it for her son, even if only once.

I brought with me a short "service" of blessing for a baby. We prayed together, I read a few words about how God loves this child who is a member of the family, and we heard a short passage from Matthew about Jesus and children. Making the sign of the cross on the little tyc's forehead with oil on my finger was so special. It was heartbreaking and endearing. It makes me sad to have to do one of these blessings, but I so enjoy being able to walk with parents through this process of caring for their deceased child and honoring his life with ritual.

The room that night was a sacred space. Her love for her son is what sanctified that sterile hospital room making it a sanctuary for God's love, expressed by a broken mother with dreams shattered who saw nothing but beauty in the tiny motionless eyes and translucent fingers of her son. I pray that in time her heart will mend.

Jesus said, "Leave the children alone, and don't try to keep them from coming to me, because the Kingdom of heaven is made up of people like this." After he put his hands on them, he went on from there. Matthew 19:45-15

Jack and Jill went up a hill

During the day, the chaplains take shifts holding the on-call pager for about 2 hours usually. It was exactly 5 minutes until I was to hand off the pager to the next person for his turn. It had been silent for me during my hours with that evil beeper on my belt. Until, my streak of silence was broken. A phone number came through. I called and spoke with the RN on the line.

"One of the surgeons wants you to come to room 948 with him." "Okay," I said, "can you tell me more about it?" "Sure," she said, "his patient expired during surgery, and he's heading up to inform the family." I knew that the work I had planned to get done that evening was now not going to happen.

The way hospitals work, it is very rare for someone to actually die during surgery. If someone is too ill, doctors will simply refuse to perform the surgery saying it's too risky (which, of course, it is), or if a patient begins to go down hill during a surgery he/she is stitched back up and sent to the ICU.

Arriving a few minutes before the surgeon, I found the RN and learned that the husband (we'll call this couple Jack and Jill) was in the room expecting his wife to be through with her procedure about now. Jack and Jill were in their mid-30s and had to young children, 3 and 4 years old. That changes things.

An entourage of about 5 people wearing light blue scrubs, hair nets and shoe coverings came onto the nursing unit. The OR staff was here. The RN and I followed them in as we crowded the room in which only Jack was present. He immediately knew something was wrong.

The doctor broke the news quickly like a machine reading a script, ending with the formal line, "...and despite our best efforts, we were unable to save her. I'm sorry for your loss." Shock. Denial. Anger. All three struck Jack at once. Then tears. Pain and numbness seemed to mix together to form an emotional concoction of surreal-ness. There's no right or easy way to do this.

Finding the breath that had been taken from him by the news, Jack asked, "What happened?" And then, I think the doctor realized that it was not only Jack's loss. The surgeon suddenly stopped being a doctor. Something changed in his voice. He told Jack they were trying to intubate her but couldn't get the tube past the mass in here trachea. They brought in experts at intubation. "I tried. He tried. We all tried, but we just couldn't..." His voiced choked up, and tears filled the eyes behind the doc's glasses. The anesthesiologist, a younger looking doctor, spoke up sharing that the medicine was right, but Jill wasn't getting enough air. They tried for 30 minutes to save her, to bring her back. But the couldn't. His face was beat red trying to suppress his emotion.

I looked at Jack. He was broken. I looked at the medical staff in the room. They were hurting. I passed out tissues to everyone there. Heads were hanging, bodies were slumped, and I realized that though these people were only recent acquaintances, they were all hurting over Jill's death. My heart broke for all of them.

Jack called his family. These phone calls are always the hardest to make. The grand parents arrived with Jack and Jill's two darling children, an angelic 4-year old girl wearing pink sweats clomping around in little black shin high snow boots, and a 3 year old boy with a toy airplane and head he was almost grown into. The boy was a little too young, but the girl knew something wasn't right. When she entered the hospital room she asked where her mommy was. And like swords plunged by an expert musketeer, those words pierced at the hearts of daddy and grandparents. And as with Jack, there is no right or easy way to do this.

They talked to her about grandpa's old dog that got old and then went to be with God. Just like uncle Joe got sick and went to be with God. "Mommy also got very sick and had to go be with God." She didn't completely understand, but she knew things weren't right. She knew she couldn't see her mommy. Two of the OR staff had remained, one was the doctor. They stood back and cried silently with other family members as this little sweet girl's big brown eyes filled with fear and uncertainty. These children's lives had just changed forever.

I spent over two hours with the family and staff. I offered tissues, hugs, consoling hands on shoulders and backs, I contacted Child Life Development to get some resources to the family, I stood outside with Jack as he smoked a much needed Swisher Sweet cigar, I held elevator doors, trash cans and offered water to Jack after he vomited in the toilet. I've come to a point where I do not need to cry during tragedies like this, but my heart breaks no less. I am grateful to have witnessed and acknowledged their pain and to have journeyed with them for a brief time. My prayers and sympathies go out to the newly single parent Jack and his two beautiful children, daily reminders of his precious Jill.

Saying hello, saying goodbye...

I was called to the 8th floor to visit with a patient and his wife. The patient had terminal cancer in his abdomen and there was nothing else the doctors could do to treat. There were no illusions about how this was going to end. Pain management and comfort care was now the highest goal.

As I entered, I noticed the patient, sitting in the bedside chair, covered in cheap hospital blankets hiccuping every second. Like clockwork, he hiccuped and took shallow breaths as he could. His wife sat on the bed edge holding his hand with the resolution of never letting go, as if she were holding her own source of life.

The patient could hardly speak. Somewhere between a whisper and a scratchy growl, his words came out faint and sincere. "I woke up this morning, and said to myself, 'I'm ready to go.'" I sat with them and listened. He expressed no qualms about death. "I'm ready to die. Not tomorrow, not in 10 minutes, now," he said while his wife could hardly keep a dry tissue for all her tears.

He was ready to say "hello" to God.

Turning to her, we discussed how difficult it is for her to be in that room. Watching her husband, suffering from unrelenting torturous hiccups, stomach pain from the cancer, and his body deteriorating, she also expressed that she wouldn't be anywhere else.

They talked about their life together and their journey through medical diagnoses and cancer treatments. She, always by his side, understood his readiness to pass from this life into death but could not ignore her own desire to keep her husband with her just a little longer. "I'm ready for it,....I'm just not ready...you know?" she said to me, with tear-filled eyes shimmering under florescent lights.

She was saying "goodbye."

I sat, and I witnessed this heart breaking and beautiful scene. Both were present with each other and at the same time present with themselves. He was in pain and wanted it to end, the only way left to him was to die. He also hurt in the thought of leaving behind his bride. She was terrified for her husband to be gone from her sight, and yet understood that his only release from suffering would come in the form of death.

It was a tender moment. My heart goes out to them both as they each make this transition, together and separately. One saying, "hello," the other saying, "goodbye."

Pain

It's hard to watch another person suffer. There's something about another person's pain that makes us (me atleast) very uncomfortable. In the hospital, I've had ample opportunity to be present when others are hurting, and so far, I haven't really figured out what to do with it yet.

I went to talk to a patient who, aside from heart problems, suffered from seizure activity in her brain. As I began to speak with her, she suddenly became silent, turned her head slowly to the left and twitched her eyes to the left as far as they would go. She was having a siezure as I sat beside her. I don't know if siezures like that are acutely painful or not, but it can't be pleasant to suddenly lose control of your body. When it was over it was like her eyes snapped back under her control and she slowly turned her head forward again.

One man, after a grueling heart surgery, could only respond to me using one word, "help." I asked if I could enter the room, and he nodded clearly fixing his attention on something not visible in the room. I soon discovered his attention was fixed on the severe pain he was experiencing. He was able to talk, but when I asked him any question the only response he would give was, "help," as he winced in pain.

I've stood over car accident victims in the trauma bay in excruciating pain to which pain killer medicine can only do so much good.

As a non-medical person in the hospital, my job is not to relieve pain. Were I a doctor or nurse or whatever, I'm sure I would be able to offer hurting patients something to relieve their suffering. But, as a chaplain, my job simply to sit there. In the pain, watching pain, feeling some pain of my own. This is an awkward thing for me. I am trained to help you deal with your emotional pain (if you want to go there), but regarding physical pain, honestly, I'm pretty useless.

So, for me, at this point in my job, I'd have to say that sitting and watching a person in pain is one of the hardest things to do. But what are my other options? I think it's bad form if the chaplain fled the room everytime somebody was hurting.

Sometimes, I'll be talking with a patient who has pain hit him all the sudden for a few moments. I sit there, and when the episode is over we continue our visit. Sometimes, it's as if nothing had happened. Sometimes we talk about the pain the frustration, anger and fear that random acute pain can cause.

So, what do I do? Suggestions are welcomed. Other chaplains reading this: what do you do with tangible pain during a visit?

Broken Femurs

Margaret Mead, a noteable anthropologist, was once asked by a student to describe the earliest sign of civilization in a given culture. Expecting her professor's answer to deal with clay pots or primitive tools, the student was surprised when Dr. Mead answered, "a healed femur." She explained that a healed femur meant that somebody cared for the injured biped. Someone else had to do the injured person's hunting and gathering until the leg healed. Compassion, then, is the first evidence of civilization.

If you had only one word to summarize Jesus' ministry told in the Bible, you might choose the word: compassion.

The English word, "compassion," is from a Latin word meaning, "to bear or feel the suffering" of another. This goes beyond an intellectual connection but to that place inside us that hurts which doctors cannot fix. The Hebrew (and Aramaic) word for compassion is curiously the plural form of the noun: "womb." There's something about compassion that, like a mother's womb, is life-giving, safe and all embracing.

You might not think so, but compassion can sometimes get you into trouble. It sure did for Jesus. During the first century, some Jewish holiness laws had become so strict that they stifled compassion (good thing that never happens today). For example, Jesus and his friends were once seen plucking some heads of grain in a field on a Saturday (Sabbath) because they were hungry. Jewish law prohibits work of any kind on the Sabbath, so they were confronted. The law prohibited hungry people from eating?!?!

Another Saturday, in the synagogue, Jesus healed a man's deformed hand. Confronted again for working on the Sabbath by the mainstream pastors of the day, Jesus explained, "What if one of you has only one sheep and it falls into a pit on the Sabbath; wouldn't you lift it out? How much more valuable is a human being than a sheep? Of course it's lawful to do good on the Sabbath."

Very simply, "our actions of love are more important that the expression of our beliefs or keeping of the law." I can think of a number of occasions in which this lesson is missed in today's world. Look at the way we often treat people who are gay, homeless people, women and migrant workers. The list goes on. If your first reaction to an illegal immigrant or a homosexual is judgment, then perhaps you have an area for learning and growing. Nobody ever said compassion is easy.

A while back, a man shot and badly injured a boy before turning the gun on himself. He wound up in the trauma bay at my hospital. Doctors in the trauma bay were cynical toward the man, and nurses were looking for their largest guage needles before inserting an IV. Though everyone remained professional, I must say, it was a hostile environment.

Later, in the ICU, my fellow chaplain had a chance to visit with the man and was faced with the delima of showing compassion to a man who shot a kid. (Love your enemies. Anyone?) As I listened to her recount the visit and procoess her feelings surrounding him I knew I had much to learn. Well, I got my chance.

Months later, after I had learned some things, I was called to visit with a woman who, hours earlier, had in a drunken stupor driven her car the wrong way down the interstate causing a head-on collision which killed one and badly injured an 8 year old girl. I will not try to replay the visit or describe my innards except to say that I was able to find a place in me that saw how broken this woman was. And it was from that place that I moved toward her and did my best to demonstrate that God still loves her. That's right, God still loves her, the driver of a car that killed and devestated lives.

Our civil laws and our social codes demand judgment upon this lady, and she deserved it. But she also deserved a bit of compassion. I hope I gave that to her. Jesus was not primarily a teacher of moral codes or correct belief systems. He was a teacher of authentic human relationships. For me, that's one reason why he's so worth following.

Lesson Learned

I visited a patient in the Coronary Care Unit during my regular rounds one day. As I entered the room I noticed that Jane Doe, an elderly patient, was intubated (breathing tube down her throat) yet also awake, which is unusual. Her hands were covered with large mittens like hospitalized boxing gloves except for one thumb and index finger with a monitor attached. The mittens were to restrict her from pulling on the incredibly uncomfortable breathing tube. She was unable to speak, use her hands or communicate her needs. Her face was so sad. It was a pitiful sight.


Not knowing exacly how to be a chaplain for her, I introduced myself, said a few other words and tried to understand her facial expression crying out to be heard. I stood in silence with her doing my best to meet her on her level.


After some time of silence with a few words sprinkled here and there she reached out her weak mitten covered hand gesturing toward something on my shirt. As I tried to identify what she wanted her two exposed fingers finally caught mine and grasped them. Then her hand, gently holding mine, lowered and rested on the bed.


I finally got the point.


I stayed with Jane for 45 minutes saying little, holding her hand much. Before I left, I placed my hand on her head to brush the hair out of her eyes. Her face fell into my hand as if it had not been touched in days. Her entire body calmed and for that brief moment she finally looked peaceful.

Some days later I returned and met Jane’s family. Upon introductions I was met by her daughter saying, “So you’re the chaplain. She said she wouldn’t have made it without you.” Floored by the comment, my lesson had been learned.


I learned that Jane needed someone to care, to be with her, to touch her and to be recognized as a person while lying rather inhumanely in a hospital bed. This taught me about the gentle power that the pastor can wield: the power to go to people where they are as Jesus did, the power to acknowledge a person's struggle and worth at the same time.


Jane did not need a sermon or religious ritual, she needed me. She needed touched and cared for, and the beauty is these are things I can do out of who I am rather than something I’ve learned.